Provider Demographics
NPI:1477560761
Name:DOUCET, DONALD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WILLIAM
Last Name:DOUCET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 ROBERTS DR
Mailing Address - Street 2:SUITE I
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-2661
Mailing Address - Country:US
Mailing Address - Phone:225-638-4885
Mailing Address - Fax:225-638-4586
Practice Address - Street 1:230 ROBERTS DR
Practice Address - Street 2:SUITE I
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2661
Practice Address - Country:US
Practice Address - Phone:225-638-4885
Practice Address - Fax:225-638-4586
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1948268Medicaid
LA1345491Medicaid
LAB61473Medicare UPIN
LA1345491Medicaid